Fatigue: Long COVID-19 or Rheumatoid Arthritis Flare?

Last updated: June 2022

The dreaded fatigue. We all get it, we all hate it, and we all understand that it is part of living with rheumatoid arthritis. It can be present all the time or accompanied by a flare.

Low blood pressure and fatigue

Since being diagnosed with COVID-19 in January of 2021, I have had some strange episodes of blood sugar and fatigue issues that have persisted.

All the typical symptoms of loss of smell and taste, body aches, and fever passed within a month. I had several episodes of low blood sugar in February, March, and April. Now, I am having high blood sugar since June 5, 2021.

A recent article has pointed out that COVID-19 can attack the pancreas and lead to high blood sugar.1 Here is the link from the National Institutes of Health (NIH): How COVID-19 Can Lead to Diabetes. I am monitoring mine every day and following up with my primary care physician.

Fatigue: long COVID-19 or RA flare?

Back to fatigue. COVID-19 led to increased fatigue for several months. It seemed to get better after my vaccines and I thought it was over.

This morning, June 21, 2021, my two alarms went off. I went to roll over out of bed, and then woke up 30 minutes later! I have been fatigued all day.

Coffee has not helped. Focusing is difficult. My morning routine took an hour instead of the usual 20 minutes. I am barely functioning at work.

Is an RA flare on the way?

So now I wonder, is it long COVID or a precursor to a rheumatoid arthritis flare?

Typically, my fatigue comes with pain and aches. Today, it is just crushing fatigue. Does that mean it is not rheumatoid arthritis or fibromyalgia? Possibly, but I do not know.

Less joint pain but persistent fatigue

It’s now June 23, 2021, and I have another wrinkle to my story. Yesterday I woke with pain all over and could barely move my fingers and toes.

I was able to get in to see the rheumatologist for a steroid shot. I took 2 3-hour naps and went to bed early. So I thought for sure it was an RA flare. Today the joint pain is less, but the fatigue is still persistent.

It is difficult to explain

Fatigue is one of those “silent” or “invisible” symptoms that are difficult to explain or categorize. Aside from rheumatologists who really listen and fellow rheumatoid arthritis warriors, people cannot understand our symptoms because they have no frame of reference.

So how do we change this? How do we create a frame of reference that people can understand?

Is it even possible? We have all attempted and failed to explain our symptoms to people without rheumatoid arthritis.

Using the flu as a frame of reference

A friend called and complained that she had the flu. She said, “You can’t imagine this! I can barely get out of bed to get to the bathroom, everything hurts!”

Instead of giving comfort, I used this as a frame of reference. I responded by saying, “Welcome to my world.”

She couldn’t believe it. She said no one could live with this pain every day! I told her that many people do.

I explained to her that her symptoms were the same as my flare symptoms. She asked, “How do you do this?” I told her I have no choice.

Please share your “frames of reference” and whether they were successful.

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